Food insecurity, dietary acid load, dietary energy density and anthropometric indices among Iranian children

Impact of SARS-CoV-2 Pandemic on food Security in Patients With chronic Kidney Disease

OBJECTIVE

The present study aims to determine the degree of Food Insecurity (FI) in adult patients with CKD during the COVID-19 pandemic, as well as the association between FI and food consumption.

METHODS

A cross-sectional study was conducted on patients with chronic kidney disease (CKD), with and without substitutive treatment, and older than 18 years of age. Food security was measured using the Mexican Food Security Scale (MFSS). Sociodemographic data and a food frequency questionnaire were obtained. Multinomial logistic regression was performed using the 4 categories of food security (food security as reference); principal component analysis was also performed to assess the relationship between food consumption patterns and sociodemographic characteristics.

RESULTS

The prevalence of FI in patients with CKD was 71.6%, the most prevalent degree of FI was moderate. As FI increased, a greater amount of beans, eggs, sweets/desserts, soft drinks, and artificial juices (P < .001) was consumed. The risk factors of FI were diabetes, hypertension, unpaid occupation, living in the country's capital, having children at home, or a decrease in income due to the pandemic. Four main components were identified that were associated with the different degrees of FI.

CONCLUSION

The present study allowed us to conclude that more than 70% of CKD patients in the study cohort had some type of FI, which makes it difficult to adhere to treatment and may increase the risk of advanced CKD. A less healthy food pattern is associated with greater FI.

Prevalence of household food insecurity among a healthy Iranian population: A systematic review and meta-analysis

Background

Food security is a fundamental human right that must be upheld to preserve excellent general welfare, and mental, physical, and social health. However, according to the United Nations Food and Agriculture Organization (FAO) report in 2020, the level of food insecurity in the world is increasing.

Objective

Determining the prevalence of food insecurity in Iran will be beneficial for Iran and other low-middle-income countries.

Methods

We searched both English and Persian (Iranian) databases including PubMed, Scopus, Web of Science, Google Scholar, SID, Irandoc, Magiran, Civilica, and Iranian Medical Sciences Theses System from 01 January 1990 to 01 February 2022. Observational studies that reported the prevalence of household food insecurity among a healthy Iranian population and assessed food insecurity at the individual or household level using validated questionnaires were included.

Results

One hundred six studies and/or theses with a total of 152, 300 participants met the review criteria. Our analyses demonstrated that the prevalence of food insecurity among the healthy Iranian population was 55.9% (95% CI: 52.6-59.2%) and the highest prevalence of food insecurity was in the western regions with 64.8% (95% CI: 57.7-72.0%). Subgroup analyses showed that food insecurity among women at 51.3% (95% CI: 45.1-57.6%) and rural inhabitants at 66.1% (95% CI: 58.8-73.4%) was significantly higher than men at 47.8% (95% CI: 41.8-53.8%) and urban residents at 47.1% (95% CI: 44.1-50.0%), respectively. Among the age groups, the highest prevalence of food insecurity was in adults at 56.5% (95% CI: 51.7-61.2%).

Conclusion

The prevalence of food insecurity in a healthy Iranian population was higher than the global average. Women, rural residents, and residents of the western regions of Iran had a higher prevalence of food insecurity. These groups should be prioritized in programs to reduce the prevalence of food insecurity in Iran.

Systematic review registration

www.crd.york.ac.uk/PROSPERO, identifier: CRD42022328473.

The association between dietary acid load and adiposity measures among children and adolescents

Background

Childhood obesity is one of the most important health problems in the present century. It is imperative to plan preventive programs through risk factor identification. The present study was conducted to examine the association between the dietary acid load (DAL) and anthropometric indices in a sample of Iranian children and adolescents.

Methods

In the current survey, students aged 11–18 years were recruited. To assess usual dietary intake, a validated self-administered 168-item food frequency questionnaire was used. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) was used to estimate DAL. The association between DAL and anthropometric indices was evaluated using logistic regression and reported as an odds ratio (OR) with a 95% confidence interval (CI).

Results

In total, 456 students (267 girls), with a mean age of 14.44 years participated in the current study. After controlling for potential confounders, the PRAL was positively associated with the risk of obesity (OR = 4.56, 95% CI: 2.26, 9.17), abdominal obesity (OR = 12.64, 95% CI: 3.05, 52.27), and adiposity based on the percent of body fat (PBF) (OR = 3.58, 95% CI: 1.83, 6.99). The NEAP was also significantly associated with the risk of obesity (OR = 5.17, 95% CI: 2.56, 10.43), abdominal obesity (OR = 15.08, 95% CI: 3.35, 67.81), and adiposity based on PBF (OR = 4.53, 95% CI: 2.30, 8.92).

Conclusion

Our findings suggest that higher adherence to the acidogenic diet, expressed as DAL, was associated with a higher risk of general and central obesity among children and adolescents.

Association between diet quality in adolescence and adulthood and knee symptoms in adulthood: a 25-year cohort study

We aimed to describe associations between diet quality in adolescence and adulthood and knee symptoms in adulthood. Two hundred seventy-five participants had adolescent diet measurements, 399 had adult diet measurements and 240 had diet measurements in both time points. Diet quality was assessed by Dietary Guidelines Index (DGI), reflecting adherence to Australian Dietary Guidelines. Knee symptoms were collected using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analysed using zero-inflated negative binomial regressions. The overall adolescent DGI was not associated with adult knee symptoms, although lower intake of discretionary foods (e.g. cream, alcohol, bacon and cake) in adolescence was associated with lower pain (mean ratio (MR) 0·96) and dysfunction (MR 0·94). The overall adult DGI was not associated with knee symptoms; however, limiting saturated fat was associated with lower WOMAC (Pain: MR 0·93; stiffness: MR 0·93; dysfunction: MR 0·91), drinking water was associated with lower stiffness (MR 0·90) and fruit intake was associated with lower dysfunction (MR 0·90). Higher DGI for dairy products in adulthood was associated with higher WOMAC (Pain: MR 1·07; stiffness: MR 1·13; dysfunction: MR 1·11). Additionally, the score increases from adolescence to adulthood were not associated with adult knee symptoms, except for associations between score increase in limiting saturated fat and lower stiffness (MR 0·89) and between score increase in fruit intake and lower dysfunction (MR 0·92). In conclusion, the overall diet quality in adolescence and adulthood was not associated with knee symptoms in adulthood. However, some diet components may affect later knee symptoms.

The Association of Dietary Energy Density and Body Composition Components in a Sample of Iranian Adults

Background: We aimed to investigate the association between the energy density (ED) of diet and body composition components in Iranian adults. Methods: We conducted a cross-sectional study on 267 adults in Tehran. We obtained ED (kcal/g) using the two most common methods: ED1, ED from foods only with the exclusion of all beverages and ED2, from foods and all beverages. Body composition was measured using a multifrequency bio-impedance analysis. To find a strong association, we used both the linear and binary regression analysis in the three adjusted models. Results: The mean of ED1 and ED2 was 1.34 ± 0.23 and 0.89 ± 0.20 kcal/g, respectively. Increasing the ED of diet in both methods was associated with a high intake of dietary fat, of saturated fatty acid (SFA), of monounsaturated fatty acid (MUFA), of polyunsaturated fatty acid (PUFA), of oleic and linoleic acids, accompanied by a low intake of fruits, vegetables, and some vitamins and minerals. There was a significant positive relationship between fat-free mass index (FFMI) and ED1 (β = 4.44, p = 0.02). However, we found no significant association between the consumption of ED1 and fat mass index (FMI) (0.28; 95% CI 0.08, 0.98; p = 0.07), and abdominal obesity (0.91; 95% CI 0.43, 1.94; p = 0.82). Also, ED2 had no association with FMI (0.86; 95% CI 0.26, 2.80; p = 0.81) and abdominal obesity (0.78; 95% CI 0.35, 1.72; p = 0.54). No significant associations were found between ED and other anthropometric indices and body composition components after considering the confounders. Conclusion: This study supports the positive association between ED and poor dietary quality. However, our findings did not show significant associations of dietary energy density (DED) with anthropometric indices and body composition components. Further well-designed studies are required to investigate the exact link between DED and body composition.

The effects of whole grain intake on anthropometric measures in overweight and obese children: a crossover randomised clinical trial

Whole-grain foods have been reported to affect body weight and satiety. However, we are aware of no study in this regard among children. The present study aimed to determine the effects of whole grain consumption on anthropometric measures in overweight or obese children. In this randomised crossover clinical trial, forty-four overweight or obese girls participated. After a 2-week run-in period, subjects were randomly assigned to either intervention (n 44) or non-intervention (n 44) groups. Subjects in the intervention group were given a list of whole-grain foods and were asked to obtain half of their grain servings from these foods each day for 6 weeks. Individuals in the non-intervention group were asked not to consume any of these foods. A 4-week washout period was applied. Then, participants were crossed over to the alternate arm. The measurements were done before and after each phase. Mean age, weight and BMI of participants were 11·2 (sd 1·49) years, 51·2 (sd 10·2) kg and 23·5 (sd 2·5) kg/m2, respectively. Despite the slight reduction in weight and BMI, there were no significant differences in changes in these anthropometric measures. We found a significant effect of whole grain intake on waist circumference (−2·7 v. 0·3 cm, P = 0·04). No significant changes in hip circumference were observed. Changes in the prevalence of overweight, obesity and abdominal obesity were not significantly different. This study indicated a beneficial effect of whole-grain foods on waist circumference in overweight children; however, these foods did not influence weight and BMI.